Predictors of Cardiac Self-Efficacy among Patients Diagnosed with Coronary Artery Disease in Tertiary Hospitals in Nepal

Abstract

Background: Cardiac self-efficacy determines how people feel, think, motivate themselves and behave with regards to improving their cardiac health subsequently preventing complications of coronary artery disease (CAD). Given almost one-third of global death is contributed by CAD with 10% of disability adjusted life years lost in low- and middle-income countries (including Nepal), it is important to identify factors that can promote cardiac self-efficacy. There are no studies in Nepal focusing on predictors of self-efficacy. Therefore, we aim to determine the predictors of cardiac self-efficacy of CAD patients in Nepal.Design and Methods: This is a cross-sectional study where we recruited 170 patients (≥30 years) diagnosed with CAD from two tertiary level hospitals. Multiple linear regression model was used to identify the predictors of cardiac self-efficacy.Results: The mean age of the participants was 60.45±10.39 years (range, 31-83). Most of the participants were diagnosed as myocardial infarction (91.2%), rest with unstable angina (6.5%) and stable angina (2.4%). The multivariate analysis shows age (p<0.001), health behaviors (p<0.001) and knowledge of the disease (p<0.001) were statistically significant predictors to cardiac self-efficacy. Every 1-year increase in age was associated with 0.23 units increase in cardiac self-efficacy score. Similarly, every unit increase in health behavior score and knowledge of disease score was associated with 0.432 units and 0.475 units increase in cardiac self-efficacy score, respectively.Conclusion: Age and health behaviors were the strongest predictors of cardiac self-efficacy followed by knowledge of the disease. We conclude that those with poor health behavior are at a greater risk of poorer cardiac self-efficacy compared to those with relatively good level of self-efficacy. Public health interventions such as awareness raising about cardiac disease and health behavior modification along with early screening, diagnosis and appropriate care are essential to improving self-efficacy and cardiac care outcomes.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having undergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized controlled trial

“…( 28 ) One study has shown that a one-unit increase in health-related behaviors and heart-related knowledge can raise self-efficacy in managing the prevention of cardiovascular diseases by 0.432 and 0.475 units, respectively. ( 29 )…”

The Relationship Between Self-Efficacy and Functional Capacity Among Discharged Heart Failure Patients in Jordan

“…This inconsistency of self-efficacy level could be attributed to many factors that can influence cardiac self-efficacy among patients, such as age, health behaviors, and knowledge of the disease, which are the strongest predictors of cardiac self-efficacy. 33 Other factors that could influence the variations in self-efficacy levels in the literature may be attributed to different cardiac populations that were recruited in previous studies, and different methodologies and research outcomes that were used in the studies. This also relates to the absence of cardiac rehabilitation programs in Jordan (and the Middle East in general).…”

“…On the other hand, the findings of the study were inconsistent with those of Barham et al, 32 who found that patients with coronary heart disease had a low self-efficacy level in a Palestinian population after hospitalization. This inconsistency of self-efficacy level could be attributed to many factors that can influence cardiac self-efficacy among patients, such as age, health behaviors, and knowledge of the disease, which are the strongest predictors of cardiac self-efficacy 33 . Other factors that could influence the variations in self-efficacy levels in the literature may be attributed to different cardiac populations that were recruited in previous studies, and different methodologies and research outcomes that were used in the studies.…”

Self-Efficacy and Quality of Life Among Coronary Heart Disease Patients: A Cross-Sectional Study

“…Several studies have demonstrated the relationship between self-efficacy and quality of life in patients with coronary heart disease (RoshanGhias et al, 2018;Sarkar et al, 2007;Shrestha et al, 2020). Selfefficacy plays a crucial role in enhancing patients' quality of life (Brink et al, 2012;Shrestha et al, 2020).…”